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Updated: Jun 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Survey of sleeping position recommendations for prematurely born infants
Nikesh Dattani1, Ravindra Bhat, Gerrard F Rafferty
1Division of Asthma, Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK.
Insights
A national campaign did not significantly change recommendations for premature infant sleep position before discharge. However, after discharge, more units discouraged prone sleeping and fewer recommended side sleeping.
Area of Science:
- Neonatal care
- Public health campaigns
- Infant safety
Background:
- Premature infants face a higher risk of sudden infant death syndrome (SIDS).
- Prone or side sleeping positions increase SIDS risk in infants.
Purpose of the Study:
- To assess the impact of the "Time to get back to sleep" campaign on UK neonatal units' recommendations.
- To evaluate changes in guidance on premature infant sleeping positions before and after discharge.
Main Methods:
- A questionnaire survey was distributed to UK neonatal units, achieving a 90% response rate.
- Responses were compared to data from a pre-campaign survey.
- Statistical analysis was used to identify significant differences in recommendations.
Main Results:
- No significant change in supine sleeping recommendations 1-2 weeks before discharge (78% vs. 83%).
- Increased provision of written information for parents (95% vs. 90%).
- Post-discharge: fewer units recommended side sleeping (8% vs. 17%) and more discouraged prone sleeping (62% vs. 38%).
Conclusions:
- Most neonatal units provide appropriate post-discharge sleeping recommendations for premature infants.
- Further education for neonatal staff on safe sleeping practices is essential.
Unlabelled:
The risk of sudden infant death syndrome is increased in prematurely born infants compared to those born at term, particularly if they are either slept prone or on their side. The aim of this study was to determine whether a national campaign "Time to get back to sleep" had influenced the recommendations made by neonatal practitioners regarding the sleeping position for prematurely born babies prior to and after neonatal unit discharge. A questionnaire survey was sent to all UK neonatal units, of which 90% responded. The results were compared to those of a survey carried out prior to the national campaign. Analysis of the responses demonstrated that there was no significant difference in the proportion of units which recommended supine sleeping at least 1-2 weeks before discharge (78% versus 83%). Still, a minority of units provided written information for staff (26% versus 33%), but a greater proportion of units provided written information for parents (95% versus 90%, p = 0.047). All units recommended supine sleeping following discharge, and compared to the results of the previous survey, a smaller proportion of units additionally recommended side sleeping after discharge (8% versus 17%, p =0.01) and a greater proportion actively discouraged prone sleeping (62% versus 38%, p < 0.0001).
Conclusions:
The majority but, importantly, not all neonatal units are giving appropriate recommendations regarding sleeping position following neonatal unit discharge. These results highlight that further education of neonatal staff regarding appropriate sleeping position for prematurely born babies remains imperative.
